Headlines about "Medicare and Medicaid"
Gathered from the web by the editors at BenefitsLink.com.
GAO Testimony: Overview of Approaches to Control Prescription Drug Spending in Federal Programs
June 24, 2009. 16 pages. Testimony given by John E. Dicken, director, health care, before the Subcommittee on Federal Workforce, Postal Service, and the District of Columbia, House Committee on Oversight and Government Reform. (U.S. Government Accountability Office)
Obama To Formally Announce Medicare Drug Costs Cuts Today
Excerpt: "The pharmaceutical industry agreed Saturday to reduce Medicare drug costs as part of health overhaul in an apparent effort to stave off potentially more-burdensome givebacks under the Democrats' health-overhaul plan. Today, President Barack Obama will make a formal announcement about the deal. The Wall Street Journal reports: 'Drug makers on Saturday outlined a proposal to forgo $80 billion in revenue over a decade, largely by covering more of the cost of brand-name prescription drugs under the federal government program for seniors. It would make up part of the $313 billion in government health-spending cuts that President Barack Obama has proposed over a decade to help pay for the overhaul plan.'" (Kaiser Family Foundation)
[Guidance Overview] CMS Update on Mandatory Insurer Reporting User Guide and Other Guidance
Excerpt: "This Capital Checkup summarizes key issues addressed in the updated guidance: New registration deadline for entities reporting only on Health Reimbursement Arrangements (HRAs), What it means for a person to be 'known to be entitled to Medicare'), and CMS's recommended process for collecting Medicare Health Insurance Claim Numbers (HICNs) or Social Security Numbers (SSNs)." (The Segal Group, Inc.)
Savings Needed for Health Expenses in Retirement: An Examination of Persons Ages 55 and 65 in 2009 (PDF)
Pages of 20 pages. Excerpt: "This report updates earlier EBRI research on estimated savings needed to cover health insurance to supplement Medicare and out-of-pocket expenses for health care services in retirement. It finds that men age 65 in 2009 retiring this year will need anywhere from $68,000?$173,000 in savings to cover health insurance premiums and out-of-pocket expenses in retirement if they want a 50?50 chance of being able to have enough money, and $134,000?$378,000 if they prefer a 90 percent chance. With their greater longevity, women will need more: a women retiring at age 65 in 2009 will need anywhere from $98,000?$242,000 in savings to cover health insurance premiums and out-of-pocket expenses inretirement for a 50?50 chance of having enough money, and $164,000?$450,000 for a 90 percent chance." (Employee Benefit Research Institute)
Medicare Beneficiaries' Out-of-Pocket Spending for Health Care Services
Excerpt: "Beneficiaries spent an average of $4,394 of their own money on health care services in 2005 -- about 28 percent of income." (AARP)
Medicare Secondary Payer User Guide Updated With Guidance for Responsible Reporting Entities and Group Health Plans
Excerpt: "EBIA Comment: ['Responsible reporting entities'] will likely welcome any assistance to deal with the thorny problem of collecting [Medicare Health Insurance Claim Number]/SSNs. It remains to be seen, of course, whether the new strategy will result in a higher level of cooperation from subscribers and their dependents. Collecting information about dependents is particularly difficult since information about them is harder to obtain and often less accurate than for subscribers. " (Employee Benefits Institute of America)
How The White House Hopes to Control Health Care Costs
Excerpt: "Senate sources confirm that the president argued in favor of a genuinely major Medicare reform -- a reform that could make Medicare the nation's most important laboratory for health care reforms." (Washington Post; free registration required)
CMS Announces 2010 Indexed Medicare Rx Amounts
Excerpt: "Recently announced 2010 limits for Medicare Part D prescription drug benefits reflect annual adjustments that affect employers' calculations when applying for the retiree drug subsidy (RDS). Upcoming changes to the RDS application process will require actuaries to register again with additional identifying information and revise how lists of covered retirees are submitted and processed. The latest update to the RDS User's Guide includes a chapter on the appeals process." (Mercer LLC)
A Summary of the 2009 Annual Reports from the Social Security and Medicare Boards of Trustees
Excerpt: "Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. This message summarizes our 2009 Annual Reports." (U.S. Social Security Administration)
Recession Drains Social Security and Medicare
Excerpt: "[The administration said that] the Medicare fund that pays hospital bills for older Americans is expected to run out of money in 2017, two years sooner than projected last year. The Social Security trust fund will be exhausted in 2037, four years earlier than predicted, it said." (The New York Times; free registration required)
2009 Medicare Trustees Report
Excerpt: "The Boards of Trustees for Medicare . . . report annually to the Congress on the financial operations and actuarial status of the program. Beginning in 2002, there is one combined report discussing both the Hospital Insurance program (Medicare Part A) and the Supplementary Medical Insurance program (Medicare Part B and Prescription Drug Coverage). . . . The Boards of Trustees issued their most recent report on May 12, 2009." (Boards of Trustees of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund via Centers for Medicare & Medicaid Services)
How Do Medicare and Employer Coverage Compare in Meeting Enrollees' Needs?
Excerpt: "One key issue in health reform concerns the relative roles of coverage offered through private insurance and public programs. This paper compares the experiences of aged Medicare beneficiaries with those of people under age sixty-five who have private employer coverage. Compared with the employer-coverage group, people in the Medicare group report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher overall satisfaction with their coverage. Although access and bill payment problems increased across the board from 2001 to 2007, the gap between Medicare and private employer coverage widened." (Health Affairs)
Annual Checkup for Social Security and Medicare
Excerpt: "The financial health of the government's two biggest benefit programs may have slipped over the past year, reflecting the deep recession that has already bitten into other areas of the budget. The trustees for Social Security and Medicare are scheduled to provide their annual report on the finances of both programs on Tuesday. In advance of the release, many private analysts said they expected both programs could run out of cash sooner than last predicted." (AP via The New York Times; free registration required)
[Guidance Overview] Requiring Older, Medicare-Eligible Retirees to Pay Larger Portion of Premium Contribution Under Health Plan Did Not Violate ADEA
Excerpt: "EBIA Comment: There have been few decisions to date applying the 2007 final EEOC regulations regarding Medicare coordination. Although not completely clear, it appears that this court found the Medicare coordination regulations and the equal benefits/equal cost rule to be sufficient, independent grounds for dismissing the retirees' claims. While that may explain the court's limited analysis of the equal benefits/equal cost rule, it would have been helpful if the court had revealed more about why it thought benefits for older and younger retirees were considered equal, given the premium differences." (Employee Benefits Institute of America)
[Guidance Overview] July 1, 2009 Implementation for New Medicare Secondary Payer Reporting
Excerpt: "Group health plans that are not voluntarily sharing data with the Centers for Medicare & Medicaid Services (CMS) will need to confirm that they are able to comply with the new reporting requirements scheduled to go into effect beginning July 1. The responsible reporting entity is typically the plan's insurer or third party administrator ? however, where the plan is self-insured and self administered, the plan administrator or fiduciary is required to report. Specific data is required to enable CMS to verify that benefits are accurately being paid where the Medicare is a secondary payer." (Deloitte via BenefitsLink.com)
Medicare Poised to Take Bigger Chunk of Social Security Checks Next Year
Excerpt: "CBO estimates the basic premium will rise to $119 next year and to $123 in 2011 for those not protected by the law. In addition, the Times reports that millions of beneficiaries also could experience higher premiums for drug coverage under Medicare Part D because there are no laws that prevent such an increase." (California HealthCare Foundation)
[Guidance Overview] The Imminent New Mandatory Medicare Secondary Payer Reporting Rules (PDF)
5 pages. Excerpt: "We recommend the following steps for each provider of liability or no-fault insurance, workers' compensation programs or insurance, and each person who self-insures such risks, including TPAs: Become familiar with the MMSEA reporting requirements. Determine whether you are a Responsible Reporting Entity. Design a process to capture required information. Register online with the Medicare Coordination of Benefits Contractor before June 30, 2009. Begin testing." (Drinker Biddle Reath LLP)
8 Tips on Paying for Health Care in Retirement
Excerpt: "1. Don't count on employer benefits. Most current employees . . . won't be eligible for retiree health insurance through their former employer . . . . Less than a third of firms with 200 or more workers offered retiree health benefits in 2008, down from the 66 percent that did so in 1988, according to a Kaiser Family Foundation survey." (U.S. News & World Report via Chicago Tribune)
[Guidance Overview] CMS's Medicare Part D Benefit Parameters for 2010
Excerpt: "EBIA Comment: The new parameters will help group health plan sponsors determine whether their plans' prescription drug coverage is creditable for 2010. This information is needed for the disclosures that must be made annually and at other specified times to Part D eligible individuals and to CMS [Centers for Medicare & Medicaid Services]." (Employee Benefits Institute of America)
[Guidance Overview] New Medicare Secondary Payer Reporting Obligations for Workers' Compensation Plans
Excerpt: "Beginning July 1, 2009, many employers and insurance companies will be required to report claims for workers' compensation claimants that are also Medicare beneficiaries to the Centers for Medicare and Medicaid Services (CMS) and become subject to a $1,000 per day per claimant penalty for failure to comply with this mandatory reporting requirement." (Littler Mendelson P.C.)
[Guidance Overview] 2010 Medicare Part D Benefit Parameters (PDF)
2 pages. Excerpt: "The Centers for Medicare and Medicaid Services (CMS) has updated the Medicare Part D standard benefit parameters and the cost thresholds and limits for qualified retiree prescription drug plans for 2010." (Buck Consultants)
[Guidance Overview] CMS Revision of Indexed Medicare Part D Amounts for 2010, Updated April 8, 2009
Excerpt: "In an April 6, 2009 announcement, the Centers for Medicare & Medicaid Services (CMS) revised and made final the indexed Medicare Part D standard benefit and Retiree Drug Subsidy (RDS) amounts for 2010, previously announced in an advance notice. This Capital Checkup features charts comparing the final 2010 numbers and the 2009 numbers." (The Segal Group, Inc.)
[Guidance Overview] New Laws And Drafting Tips for Welfare Plans In 2009
52 slides from the firm's March 26 presentation. Excerpt: "Federal COBRA Premium Subsidy for Involuntary Terminations; Children's Health Insurance Program (CHIP) Reauthorization Act; Centers for Medicare and Medicaid (CMS) Reporting Changes; Drafting Tips: Strengthen Litigation Protections; Plan Statute of Limitations and Venue; Plan Definition of 'Spouse'." (Sidley Austin LLP)
CMS Issues Retiree Drug Subsidy User Guide and New FAQs
Excerpt: "Employers applying for the Medicare Part D retiree drug subsidy (RDS) now have additional resources on the RDS application and reconciliation process. CMS has issued a new RDS User Guide, which includes information from many how-to documents on its website. The agency also has released eight frequently asked questions addressing how to correct submitted drug costs, payment requests or retiree lists after an application has completed reconciliation." (Mercer LLC)
[Guidance Overview] CMS Update of Creditable Coverage Disclosure to CMS Form
Excerpt: "EBIA Comment: Happily, there are few changes to the Disclosure to CMS Form, and none of them are rocket science. Most seem aimed at fixing practical problems raised by how individuals were filling out the previous version of the Form." (Employee Benefits Institute of America)
House Takes Up a Plan Tied to Health Care Overhaul
Excerpt: "House Democrats pressed a budget plan Wednesday to make it easier to pass health care legislation backed by President Barack Obama, but their GOP rivals in the Senate preserved their ability to block upcoming legislation on global warming. As debate continued on nonbinding Democratic budget plans largely mimicking President Barack Obama's $3.6 trillion budget proposal, Republicans in the House offered an alternative that would eventually end the Medicare program as it is presently known." (AP via Yahoo! News)
[Guidance Overview] Medicare Part D: Optimizing the Opportunities for Employer Plans (PDF)
5 pages. The article discusses the pluses and minuses of options. (International Foundation of Employee Benefit Plans via Milliman)
[Guidance Overview] Preparing for and Understanding the New Medicare Reporting Requirements
Excerpt: "Because most companies have already developed reporting policies in workers' compensation cases, they simply need to formalize and expand those policies to include group health plans, liability insurance (including self-insurance), and no-fault insurance as well. The sooner a Medicare eligible claimant or covered individual can be identified by an Insurer, the easier it will be to coordinate with CMS and guarantee that Medicare's interests are protected in the settlement -- thereby relieving the Insurer of any liability to Medicare." (Troutman Sanders LLP)
[Guidance Overview] New Medicare Reporting Requirements (PDF)
5 pages. Excerpt: "In general, effective January 1, 2009, insurers, third party administrators, and administrators of self-insured and self-administered group health plans must collect specified information from plan participants and report this information to CMS. If your group health plan's third party administrator does not already have a voluntary data sharing arrangement with CMS, implementation begins April 1, 2009." (Bryan Cave LLP)
[Guidance Overview] Indexed Medicare Part D Amounts for 2010
Excerpt: "The Centers for Medicare & Medicaid Services (CMS) has announced the indexed Medicare Part D standard benefit and Retiree Drug Subsidy (RDS) amounts for 2010. This Capital Checkup features charts comparing the 2010 numbers and the 2009 numbers." (The Segal Group, Inc.)
How Effectively Does the American Recovery and Reinvestment Act Help Laid-Off Workers and States Cope with Health Care Costs?
Excerpt: "A new analysis from the Urban Institute concludes that these provisions are likely to achieve only partial success." (The Urban Institute via Robert Wood Johnson Foundation)
[Guidance Overview] CMS Updates Mandatory Insurer Reporting Requirements and User Guide
Excerpt: "The Centers for Medicare & Medicaid Services (CMS) has revised its guidance on new data-reporting obligations for group health plans (GHPs) and their insurers and third party administrators (TPAs) that were effective January 1, 2009. . . . The rules will require insurers, third party administrators (TPAs) and a plan administrator or fiduciary of a self-insured/self-administered group health plan to collect data for certain classes of participants and beneficiaries -- including Social Security Numbers (SSNs) or Medicare Health Insurance Claim Numbers (HICNs) -- and electronically file the information with Medicare in accordance with detailed rules established by CMS." (The Segal Group, Inc.)
[Opinion] Medicare Part D Is an Example of Bad Policy
Excerpt: "GENERATING efficiency in the health-care market will be one of President Obama's greatest challenges. To do this, he will have to create meaningful competition between drug companies, and between public and private plans. Congress's attempt at market-driven health care offers good instruction in what not to do. Medicare Part D, the prescription benefit that went into effect three years ago, was supposed to let the elderly get their medicines more cheaply by creating competition between private insurers. Yes, the program has undeniably improved access to prescriptions. But the cost to taxpayers has been 3.5 times the market value of those prescriptions, according to a study in the journal Health Affairs." (The New York Times; free registration required)
[Opinion] Principles for a New Retirement System in the USA (PDF)
49 pages. Excerpt: "Retirement USA is an initiative developed by organizations representing workers and retirees that are committed to working for a universal, secure, and adequate private retirement system for the future that supplements Social Security. The organizations launching the initiative are the Economic Policy Institute, the National Committee to Preserve Social Security and Medicare, the Pension Rights Center, and the Service Employees International Union. This working paper documents the need for a new system, details principles that should guide the development of a new system, and provides examples of plans and proposals that incorporate these principles." (Retirement USA)
U.S. Births Break Baby Boom Record
Excerpt: "The 4,317,119 births, reported by federal researchers Wednesday, topped a record first set in 1957 at the height of the baby boom. . . . On average, a U.S. woman has 2.1 babies in her lifetime. That's the 'magic number' required for a population to replace itself. Countries with much lower rates -- such as Japan and Italy -- face future labor shortages and eroding tax bases as they fail to reproduce enough to take care of their aging elders." (AP via ChicagoTribune.com)
[Guidance Overview] CMS Delay of MSP Mandatory Reporting for HRAs and Provision of Other Guidance for Group Health Plans
Excerpt: "CMS has updated the User Guide for group health plans on its Medicare Secondary Payer (MSP) mandatory reporting website. Like the earlier versions of the guide . . ., the updated version covers a wide range of topics relevant for the 'responsible reporting entities' (RREs) who must provide information to CMS in order to help CMS identify situations in which the plans are (or have been) primary to Medicare." (Employee Benefits Institute of America)
[Guidance Overview] Part D Plans Have Only One Month to Comply With E-Prescribing Rules
Excerpt: "With just a month to go before the April 1, 2009, compliance deadline, some Part D plans still are not ready to support some e-prescribing technologies outlined by CMS in an April 2008 final rule. And plan sponsors can expect more e-prescribing rules from CMS -- possibly every 12 to 24 months, one industry insider predicts -- as more providers adopt e-prescribing technology, spurred by incentives created by the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) and funding provided by the economic stimulus law signed Feb. 17 by President Obama." (AISHealth.com)
[Guidance Overview] Recent Legislation Requires Numerous Changes to Group Health Plans
Material covered includes coordination with SCHIP and Medicaid and New Privacy Restrictions in the Stimulus Package. (Troutman Sanders LLP)
[Guidance Overview] CHIPRA: How it Affects Your Group Health Plan
Excerpt: "On February 4, 2009, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was signed into law by President Obama. CHIPRA allows states to subsidize premiums for employer-provided group health coverage for eligible children, but it also imposes certain requirements on plan sponsors. . . . Plan sponsors should notify their employees with regard to their special enrollment rights as soon as possible, but no later than April 1, 2009. They should provide disclosures to employees once HHS issues its model notice, and provide disclosure to state agencies once HHS and the Department of Labor issue model forms." (McDermott Will & Emery)
[Guidance Overview] New Federal SCHIP Law Requires Amendments to Employers' Health and Cafeteria Plans
Excerpt: "Before April 1, 2009, you will need to amend your health plan and your cafeteria plan to accommodate the new qualifying event special enrollment rights. Also, assess whether your health plan's coordination of benefit rules need to be updated to reflect that SCHIP supplemental coverage will be a secondary payer to your plan." (TRI-AD)
[Opinion] We Need Health Care Reform, Not an Entitlements Commission
Excerpt: "In response to pressure from Blue Dog Democrats, the administration is hosting a 'fiscal responsibility summit' on February 23. Though it remains unclear what will come out of this process, some press reports, notably a Wall Street Journal article, claim the president 'gave the nod' to an entitlements commission whose recommendations would be put to an up-down vote before Congress. This may be premature, but it has caused understandable dismay among advocates gearing up for a universal health care offensive who now face the prospect of again playing defense on Social Security. We hope that the president will reject the idea of bypassing Congress, and use the occasion of the summit to make clear that we do not have a fiscal deficit problem so much as a problem of spiraling health care costs throughout the economy, not just in government programs like Medicare and Medicaid." (Economic Policy Institute)
The Stimulus Bill's Effect on the Health Care Industry (PDF)
5 pages. Excerpt: "[The America Recovery and Reinvestment Act of 2009] provides significant funding for research on the comparative effectiveness of items and services, increases the reach of the Health Insurance Portability and Accountability Act of 1996 and the rules promulgated thereunder ('HIPAA'), provides incentives to develop and encourage adoption of health information technology ('HIT'), and makes changes to certain Medicare and Medicaid payments for hospitals and hospices." (Winston & Strawn LLP)
[Guidance Overview] CHIP Reauthorization Act Expansion of Special Enrollment Rights and Creation of New Notice and Disclosure Obligations for Group Health Plans
Excerpt: "The Act allows states to subsidize premiums for employer-provided group health coverage for eligible children and families. The Act also amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for special enrollment rights, new notice and disclosure obligations, and penalties for non-compliance." (Seyfarth Shaw LLP)
[Guidance Overview] CHIP Reauthorization Requires Fast Action by Group Health Plans, Including Multiemployer Plans (PDF)
2 pages. Excerpt: "The primary purpose of the Children's Health Insurance Program Reauthorization Act of 2009, which President Obama signed into law on February 4, 2009, is to reauthorize the State Children's Health Insurance Program (SCHIP or CHIP) through 2013. However, the law also includes provisions aimed at coordinating group health plan coverage with CHIP and Medicaid coverage." (The Segal Group, Inc.)
[Guidance Overview] Health Plan Insurer Could Not Terminate COBRA Coverage When Qualified Beneficiary Became Covered Under Medicaid
Excerpt: "EBIA Comment: Plan administrators often confuse the rules for Medicare under Title XVIII of the Social Security Act (SSA) (which provides health coverage to individuals on the basis of age, disability, or end-stage renal disease), and Medicaid under Title XIX of the SSA (which generally provides health coverage to low-income individuals) and how they interact with employer-sponsored group health plans. As this case illustrates, ERISA broadly prohibits a health plan from taking into account an individual's Medicaid eligibility. On the other hand, COBRA coverage may be terminated early if, after electing COBRA, a qualified beneficiary becomes entitled to benefits under Medicare. Although this court did not specifically address this distinction, this case is a good reminder that the COBRA early termination rule for Medicare entitlement does not extend to Medicaid." (Employee Benefits Institute of America)
Ideas that Could Save NYC Money Include Health Insurance Cuts
Excerpt: "Establishing a four-day, 36-hour workweek for some 40,000 New York City employees could save $32.6 million next year. Deferring health insurance coverage for new employees until they have worked for three months would save $45 million each year. And reducing the Medicare Part B reimbursements for city retirees to 50 percent from 100 percent would save the city $93.5 million in 2011. Those are the biggest of 18 new cost-saving measures evaluated in a report, 'Budget Options for New York City,' an annual document that the city's Independent Budget Office has published each year since 2002." (The New York Times; free registration required)
Senate Finance Committee Side-by-Side Chart Comparing Tax Provisions of House and Senate Stimulus Measures (PDF)
Excerpt: "This chart indicates notable differences between the Senate-passed and the House-passed versions of the American Recovery and Reinvestment Act of 2009. This chart includes amendments accepted by the Senate, including the Collins-Nelson (NE) compromise amendment. Additional minor differences, such as the commissioning of various studies in the two bills, may exist[.]" (U.S. Senate Committee on Finance via American Benefits Council)
American Recovery and Reinvestment Act: Summary of Health and Income Support Provisions in Conference Agreement (PDF)
3 pages. Includes information on Health insurance assistance and health information technology. (American Benefits Council)
Congress Reaches Deal on Stimulus Plan
Excerpt: "Many Democrats would have preferred a larger bill, but agreed to pare back, including cuts to favored education and health programs, to win three crucial Republican votes in the Senate. 'Legislation is the art of compromise, consensus building, and that's what we did,' the Senate majority leader, Harry Reid of Nevada, said in announcing the accord. The House was poised for a final vote as early as Friday, with the Senate to follow, clearing the way for President Obama to sign the bill by Monday." (The New York Times; free registration required)
[Guidance Overview] New Law Establishing Additional Special Enrollment Rights, Notice, and Disclosure Obligations for Group Health Plans
Excerpt: "EBIA Comment: HIPAA already provides special enrollment rights upon certain losses of eligibility for group health coverage or health insurance coverage, and upon the acquisition of a new spouse or dependent by marriage, birth, adoption, or placement for adoption. The new law goes further to allow special enrollment as a result of loss of eligibility under a Medicaid plan or CHIP and upon becoming eligible for a premium assistance subsidy under Medicaid or CHIP. In contrast to the other special enrollment rights, which require plans to allow enrollment for at least 30 days after loss of other coverage or acquisition of a new dependent (unless a longer period is provided in the plan document), the new special enrollment rights include a 60-day period for requesting coverage." (Employee Benefits Institute of America)
Finding Health Insurance When You Lose Your Job (PDF)
12 pages. Excerpt: "[The publication] is designed to help consumers who've lost their health coverage sort through possible options for new coverage, including COBRA, Medicaid, CHIP, other federal and state programs, and the individual market." (Families USA)
[Guidance Overview] CMS Requests Comments on Proposed Changes to RDS Subsidy Calculation
Excerpt: "The Centers for Medicare & Medicaid Services (CMS) is concerned that certain new requirements it has established for Medicare Part D plans (i.e., reporting the pass-through prices instead of lock-in prices, and treating amounts retained by the pharmacy benefit manager or other intermediary contracting organization as administrative costs) will, if applied to the retiree drug subsidy program, induce employers to terminate their programs or place their retirees in a Part D plan because of the reduced subsidy. As a result, CMS has postponed applying these changes to the retiree drug subsidy program and is requesting further comments. 74 Federal Register 1494 & 1550 (January 26, 2009)." (Deloitte LLP via BenefitsLink.com)
[Guidance Overview] Your Medicare Part D Disclosure to CMS May Be Due Soon
Excerpt: "This filing requirement applies to health plans that cover any individuals who are eligible for the Medicare Part D prescription drug program, whether as active employees, spouses, dependents, or retirees. There are a few limited exemptions for plans that contract with a Medicare Part D plan or that contract directly with Medicare to become a Part D plan, and for retiree plans where an employer has successfully applied for the retiree drug subsidy. No disclosures are required for health flexible spending accounts (FSAs) or health savings accounts (HSAs); but disclosures are required for Health Reimbursement Arrangements (HRAs) either on a stand-alone basis or, more likely, in connection with a high deductible health plan, if the HRA reimburses prescription drug expenses." (Warner Norcross & Judd LLP)
An Analysis of Health Care Spending by Medicare Households (PDF)
16 pages. Excerpt: "In this paper, we analyze health care spending as a share of total household expenditures, rather than as a share of income, to assess how health-related expenditures compare with other spending priorities among Medicare households, including both the elderly and younger adults with disabilities. Using data from the 2006 Consumer Expenditure Survey, we examine spending on health care relative to other goods and services, such as housing, transportation, and food. We also assess the extent to which health care spending as a share of total expenditures varies by household characteristics, such as poverty level and geographic area, and examine the subcomponents of health care spending, including premiums, prescription drugs, and medical services." (Kaiser Family Foundation)
Take-Up of Medicare Part D: Results from the Health and Retirement Study
Excerpt: "We analyze data from the Health and Retirement Study on senior citizens' take-up of Medicare Part D. Take-up among those without drug coverage in 2004 was high; about fifty to sixty percent of this group have Part D coverage in 2006. Only seven percent of senior citizens lack drug coverage in 2006 compared with 24 percent in 2004. We find little circumstantial evidence that Part D crowded out private coverage in the short run, since the persistence of employer coverage was only slightly lower in 2004 -- 2006 than it was in 2002 -- 2004." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
The Effects of the Medicare Part D Coverage Gap on Drug Spending
Excerpt: "We calculated prescription drug usage in two groups of Medicare beneficiaries: employer group with no coverage gap, and individual Part D group with no coverage or some generic drug coverage in the coverage gap. Among those with employer coverage, 40 percent reached the doughnut hole, compared with 25 percent of those without such coverage. Overall, 5 percent went through the doughnut hole to reach the catastrophic coverage level. Those lacking coverage in the doughnut hole reduced their drug use by 14 percent; those with generic coverage reduced their use by 3 percent. Coverage of generic drugs with a $0-$10 copayment in the doughnut hole could be financed by, at most, a six-to-nine-percentage-point increase in initial coinsurance." (Health Affairs)
The Effect of Medicare Part D Coverage on Drug Use and Cost Sharing Among Seniors Without Prior Drug Benefits
Excerpt: "This study evaluates the effect of Medicare Part D among seniors who previously lacked drug coverage, using time-trend analyses of patient-level dispensing data from three pharmacy chains. Of 114,766 seniors without drug benefits, 55 percent initiated drug insurance under Part D. After the penalty-free Part D enrollment period, use of statins, clopidogrel, and proton pump inhibitors stabilized at levels ranging from 11 percent to 37 percent above the trend that would have been expected if Part D had not been implemented." (Health Affairs)
Boston Globe Examines Debate Over Cost Effectiveness of Mail-Order Pharmacies
Excerpt: "Some mail-order pharmacy owners have told the Obama administration that Medicare spending could be reduced and quality could be improved if more beneficiaries ordered their medications by mail, the Boston Globe reports." (Kaiser Family Foundation)
Insurers Overcharged Medicare for Prescriptions, Report Finds
Excerpt: "If you buy medicine through Medicare's prescription drug program, you could be paying too much. The taxpayers who finance Medicare aren't doing too well, either. Insurance companies involved in the Medicare prescription drug benefit have overcharged subscribers and taxpayers by several billion dollars, according to the inspector general for the Department of Health and Human Services. Eighty percent of the participating insurance companies owe the program an estimated $4.4 billion for 2006 alone." (The Miami Herald)
House Stimulus Bill Widens Healthcare
Excerpt: "For the first time ever, newly unemployed workers and their families will be eligible for Medicaid coverage and healthcare subsidies if the economic stimulus package passed by the House Wednesday becomes the law of the land. Those are just two of the healthcare initiatives included in the omnibus $819 billion stimulus bill. They're aimed at pumping cash into the ailing economy at the same time they shore up the nation's unravelling healthcare system." (The Christian Science Monitor)
The links shown above have been gathered from the web by the editors at BenefitsLink.com. Each article's publisher is shown above in parentheses. Opinions expressed in each article are those of the article's publisher, not necessarily those of BenefitsLink.com, Inc. or any web site that displays these headlines in a "frame." You should contact the listed publisher for copyright information about any particular article or to inquire into the right to use the article in any manner.